Fort Myers Centre for Facial Plastic and Laser Surgery, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME0068103 Issued in FL

Legal business name

FORT MYERS CENTRE FOR FACIAL PLASTIC AND LASER SURGERY, INC.

Practice address

15721 New Hampshire CT
Fort Myers, FL 33908-4176

Phone

(239) 481-4911

Fax

(239) 481-6360

NPI assigned

Oct 22, 2007

Last updated

Sep 23, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Douglas M Stevens, MD

Title

Doctor

Phone

(239) 481-4911

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John H. Adams, M.S., CCC-A

  • Audiologist-Hearing Aid Fitter
  • Fort Myers, FL
  • NPI 1972593796
  NPD (past)
• Maura Chippendale, AUD., FAAA

  • Audiologist
  • Cape Coral, FL
  • NPI 1285624247
  NPD (past)
• Stephen A Prendiville, M.D.

  • Specialist
  • Fort Myers, FL
  • NPI 1558309054
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253664000000",
    "number": "1255520714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15721 NEW HAMPSHIRE CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084176",
            "telephone_number": "239-481-4911",
            "fax_number": "239-481-6360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15721 NEW HAMPSHIRE CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084176",
            "telephone_number": "239-481-4911",
            "fax_number": "239-481-6360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT MYERS CENTRE FOR FACIAL PLASTIC AND LASER SURGERY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2009-09-23",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "239-481-4911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0068103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "040012514",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "32891",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5091536",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fiorella Forgey
• Brooke Lyall Foris, PSY.D.
• Ivian Forjans Perez
• Jacquelyn Rae Forsythe, ARNP
• Fort Myers Central Chiropractic LLC
• Fort Myers Children's Surgery Center, LLC (Southwest Florida Institute of Ambulatory Surgery Inc)
• Fort Myers Chiropractic & Nutrition Center, Inc.
• Fort Myers Chiropractic Studio LLC
• Fort Myers Dental Arts
• Fort Myers Dermatopathology

• Specialist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.